加味四君子汤联合FOLFOX4化疗方案治疗脾虚湿盛型晚期结直肠癌临床研究

Clinical Study on Modified Sijunzi Decoction Combined with FOLFOX4 Chemotherapy Regimen for Advanced Colorectal Cancer with Predominant Dampness due to Spleen Deficiency

目的:观察加味四君子汤联合FOLFOX4化疗方案治疗脾虚湿盛型晚期结直肠癌患者的临床疗效。方法:选取60例脾虚湿盛型晚期结直肠癌患者作为研究对象,采用随机数字表法分为对照组和观察组各30例。2组均应用FOLFOX4化疗方案治疗,观察组加予加味四君子汤治疗。2组均治疗3个月。治疗前和治疗3个月后,评定中医证候评分,检测肿瘤标志物[癌胚抗原(CEA)、糖类抗原(CA199)]、评价健康状态[karnofsky功能状态评分表(KPS)评分]。比较2组临床疗效。统计治疗期间2组患者不良反应的发生情况。结果:治疗3个月后,观察组总有效率83.33%,高于对照组(56.67%),差异有统计学意义(P<0.05)。2组食后腹胀、食少纳呆、倦怠乏力、大便稀溏评分和中医证候总分均较治疗前降低(P<0.05)。观察组食后腹胀、食少纳呆、倦怠乏力、大便稀溏评分和中医证候总分均低于对照组(P<0.05)。2组CEA、CA199值均较治疗前下降(P<0.05),观察组CEA、CA199值均低于对照组(P<0.05)。2组KPS评分均高于治疗前(P<0.05)。观察组KPS评分高于对照组(P<0.05)。观察组不良反应发生率40.00%,低于对照组(73.33%),差异有统计学意义(P<0.05)。结论:采用加味四君子汤联合FOLFOX4方案治疗脾虚湿盛型晚期结直肠癌患者临床疗效明显,不但能有效缓解临床症状,抑制病情进展,同时还能改善患者的健康水平,提升治疗的安全性。

Objective:To observe the clinical effect of modified Sijunzi Decoction combined with FOLFOX4 chemotherapy regimen on patients with advanced colorectal cancer with predominant dampness due to spleen deficiency syndrome.Methods:A total of 60 cases of patients with advanced colorectal cancer with predominant dampness due to spleen deficiency syndrome were selected as research objects and divided into the control group and the observation group according to the random number table method,with 30 cases in each group.Both groups were treated with FOLFOX4 chemotherapy regimen,and the observation group was additionally treated with modified Sijunzi Decoction.Both groups were treated for three months.Before treatment and after 3-month treatment,traditional Chinese medicine(TCM)syndrome scores were assessed;tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen(CA199)]were detected;health status[karnofsky performance status(KPS)score]was evaluated.The clinical effects were compared between the two groups.During treatment,the incidences of adverse reactions in the two groups were recorded.Results:After three months of treatment,the total effective rate was 83.33%in the observation group,higher than that of 56.67%in the control group,the difference being significant(P<0.05).The scores of abdominal distension after meal,torpid intake,fatigue,lack of strength and loose stool and the total scores of TCM syndrome in the two groups were decreased when compared with those before treatment(P<0.05).The scores of abdominal distension after meal,torpid intake,fatigue,lack of strength and loose stool and the total scores of TCM syndrome in the observation group were lower than those in the control group(P<0.05).The values of CEA and CA199 in the two groups were decreased when compared with those before treatment(P<0.05),and the values of CEA and CA199 in the observation group were lower than those in the control group(P<0.05).KPS scores in the two groups were increased when compared with those before treatment(P<0.05),and the KPS score in the observation group was higher than that in the control group(P<0.05).The incidence of adverse reactions was 40.00%in the observation group,lower than that of 73.33%in the control group,the difference being significant(P<0.05).Conclusion:Modified Sijunzi Decoction combined with FOLFOX4 chemotherapy regimen has a significant clinical effect in the treatment of patients with advanced colorectal cancer with predominant dampness due to spleen deficiency syndrome,which can not only effectively alleviate clinical symptoms and inhibit the progression of disease,but also improve the health level of patients and enhance the treatment safety.